scholarly journals Radiological Society of North America (RSNA) Expert Consensus Statement Related to Chest CT Findings in COVID-19 Versus CO-RADS: Comparison of Reporting System Performance Among Chest Radiologists and End-User Preference

2020 ◽  
pp. 084653712096891
Author(s):  
Siobhan B. O’ Neill ◽  
Danielle Byrne ◽  
Nestor L. Müller ◽  
Sabeena Jalal ◽  
William Parker ◽  
...  
Keyword(s):  
Predictive Value ◽  
Consensus Statement ◽  
Reporting System ◽  
Chest Ct ◽  
Observer Agreement ◽  
Expert Consensus ◽  
User Preference ◽  
End User ◽  
Predictive Values ◽  
Reporting Systems

Purpose: The RSNA expert consensus statement and CO-RADS reporting system assist radiologists in describing lung imaging findings in a standardized manner in patients under investigation for COVID-19 pneumonia and provide clarity in communication with other healthcare providers. We aim to compare diagnostic performance and inter-/intra-observer among chest radiologists in the interpretation of RSNA and CO-RADS reporting systems and assess clinician preference. Methods: Chest CT scans of 279 patients with suspected COVID-19 who underwent RT-PCR testing were retrospectively and independently examined by 3 chest radiologists who assigned interpretation according to the RSNA and CO-RADS reporting systems. Inter-/intra-observer analysis was performed. Diagnostic accuracy of both reporting systems was calculated. 60 clinicians participated in a survey to assess end-user preference of the reporting systems. Results: Both systems demonstrated almost perfect inter-observer agreement (Fleiss kappa 0.871, P < 0.0001 for RSNA; 0.876, P < 0.0001 for CO-RADS impressions). Intra-observer agreement between the 2 scoring systems using the equivalent categories was almost perfect (Fleiss kappa 0.90-0.92, P < 0.001). Positive predictive values were high, 0.798-0.818 for RSNA and 0.891-0.903 CO-RADS. Negative predictive value were similar, 0.573-0.585 for RSNA and 0.573-0.58 for CO-RADS. Specificity differed between the 2 systems, 68-73% for CO-RADS and 52-58% for RSNA with superior specificity of CO-RADS. Of 60 survey participants, the majority preferred the RSNA reporting system rather than CO-RADS for all options provided (66.7-76.7%; P < 0.05). Conclusions: RSNA and CO-RADS reporting systems are consistent and reproducible with near perfect inter-/intra-observer agreement and excellent positive predictive value. End-users preferred the reporting language in the RSNA system.

scholarly journals RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seyhmus Kavak ◽  
Recai Duymus
Keyword(s):  
Consensus Statement ◽  
Chest Ct ◽  
Classification Systems ◽  
Expert Consensus ◽  
British Society ◽  
Thoracic Imaging ◽  
Predictive Values ◽  
Ct Findings ◽  
Consensus Statements ◽  
Good Agreement

Abstract Background This study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement. Methods In this study, 903 patients who had admitted to the emergency department with a pre-diagnosis of COVID-19 between 1 and 18 July 2020 and had chest CT. Two radiologists classified the chest CT findings according to the RSNA and BSTI consensus statements. The performance, sensitivity and specificity values of the two classification systems were calculated and the agreement between the observers was compared by using kappa analysis. Results Considering RT-PCR test result as a gold standard, the sensitivity, specificity and positive predictive values were significantly higher for the two observers according to the BSTI guidance statement and the RSNA expert consensus statement (83.3%, 89.7%, 89.0%; % 81.2,% 89.7,% 88.7, respectively). There was a good agreement in the PCR positive group (κ: 0.707; p < 0.001 for BSTI and κ: 0.716; p < 0.001 for RSNA), a good agreement in the PCR negative group (κ: 0.645; p < 0.001 for BSTI and κ: 0.743; p < 0.001 for RSNA) according to the BSTI and RSNA classification between the two radiologists. Conclusion As a result, RSNA and BSTI statement provided reasonable performance and interobservers agreement in reporting CT findings of COVID-19. However, the number of patients defined as false negative and indeterminate in both classification systems is at a level that cannot be neglected.

scholarly journals Comparison of the Main Staging Systems for Assessing the Severity of Lung Injury in Patients with COVID-19 and Evaluation of Their Predictive Value

2021 ◽  
Vol 102 (5) ◽  
pp. 296-303
Author(s):  
Y. S. Kudryavtsev ◽  
M. M. Beregov ◽  
A. B. Berdalin ◽  
V. G. Lelyuk
Keyword(s):  
Lung Tissue ◽  
Predictive Value ◽  
Prognostic Value ◽  
Time Course ◽  
Fatal Outcome ◽  
Chest Ct ◽  
Viral Pneumonia ◽  
Maximum Magnitude ◽  
Predictive Values ◽  
Staging Systems

Objective: to compare the results of staging the severity of viral pneumonia in patients with COVID-19 based on the results of chest computed tomography (CT) using the empirical visual scale CT 0–4 and chest CT severity score (CT-SS) point scale, as well as to assess their prognostic value.Material and methods. Chest CT scans and anamnestic data in patients hospitalized to a non-specialized center repurposed for the treatment of new coronavirus infection, were analyzed. Chest CT analysis was performed by two radiologists using CT 0–4 and CT-SS scales.Results. The time course of changes in the severity of lung parenchymal lesions, by using both scales, was found to be similar: the maximum magnitude of lung tissue changes was recorded on day 5 of the disease. In cases of death, there was a significantly more extensive lung parenchymal involvement at admission to the center than in recovered patients, which was also true for both CT data assessment systems. Bothscales demonstrated comparable diagnostic and prognostic value: there were no statistically significant differences in sensitivity, specificity, and predictive value of a fatal outcome. Both the CT 0–4 scales and the CT-SS are based on the estimation of the volume of the affected lung tissue, but when the CT 0–4 scale was employed, additional criteria were used in some cases: the presence of hydrothorax and the determination of the maximum score for the most affected lung. Not all patients with a pronounced CT picture of viral pneumonia had a fatal outcome, which may indicate the presence of other factors that increase its risk.Conclusion. Both CT 0–4 and CT-SS scales have similar predictive values. The greater severity of parenchymal damage assessed by these CT scales was associated with the higher mortality rate.

scholarly journals RSNA Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19: Interobserver Agreement Between Chest Radiologists

2020 ◽  
pp. 084653712093832 ◽  
Author(s):  
Danielle Byrne ◽  
Siobhan B. O’Neill ◽  
Nestor L. Müller ◽  
C. Isabela Silva Müller ◽  
John P. Walsh ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Consensus Statement ◽  
Chest Ct ◽  
Reporting Guidelines ◽  
Expert Consensus ◽  
Strong Correlations ◽  
Radiological Society ◽  
Ct Findings ◽  
Polymerase Chain ◽  
Ct Studies

Purpose: To assess the interobserver variability between chest radiologists in the interpretation of the Radiological Society of North America (RSNA) expert consensus statement reporting guidelines in patients with suspected coronavirus disease 2019 (COVID-19) pneumonia in a setting with limited reverse transcription polymerase chain reaction testing availability. Methods: Chest computed tomography (CT) studies in 303 consecutive patients with suspected COVID-19 were reviewed by 3 fellowship-trained chest radiologists. Cases were assigned an impression of typical, indeterminate, atypical, or negative for COVID-19 pneumonia according to the RSNA expert consensus statement reporting guidelines, and interobserver analysis was performed. Objective CT features associated with COVID-19 pneumonia and distribution of findings were recorded. Results: The Fleiss kappa for all observers was almost perfect for typical (0.815), atypical (0.806), and negative (0.962) COVID-19 appearances ( P < .0001) and substantial (0.636) for indeterminate COVID-19 appearance ( P < .0001). Using Cramer V analysis, there were very strong correlations between all radiologists’ interpretations, statistically significant for all (typical, indeterminate, atypical, and negative) COVID-19 appearances ( P < .001). Objective CT imaging findings were recorded in similar percentages of typical cases by all observers. Conclusion: The RSNA expert consensus statement on reporting chest CT findings related to COVID-19 demonstrates substantial to almost perfect interobserver agreement among chest radiologists in a relatively large cohort of patients with clinically suspected COVID-19. It therefore serves as a reliable reference framework for radiologists to accurately communicate their level of suspicion based on the presence of evidence-based objective findings.

scholarly journals COVID-19 Pneumonia: Inter-Observer Agreement and Diagnostic Accuracy of Chest CT in Patients with Intermediate Clinical Probability

2020 ◽  
Author(s):  
Anne-Laure BRUN ◽  
Alexia GENCE-BRENEY ◽  
Julie TRICHEREAU ◽  
Marie-Christine BALLESTER ◽  
Marc VASSE ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Predictive Value ◽  
Chest Ct ◽  
Observer Agreement ◽  
Kappa Statistics ◽  
Operating Characteristics ◽  
Rt Pcr ◽  
Clinical Probability ◽  
Chest Ct Scan

Abstract Objectives To assess inter-reader agreements and diagnostic accuracy of chest CT to identify COVID-19 pneumonia in patients with intermediate clinical probability during an acute disease outbreak.Methods:From March 20 to April 8, consecutive patients with intermediate clinical probability of COVID-19 pneumonia underwent a chest CT scan. Two independent chest radiologists blinded to clinical information and RT-PCR results retrospectively reviewed and classified images on a 1-5 confidence level scale for COVID-19 pneumonia. Agreements between radiologists were assessed with kappa statistics. Diagnostic accuracy of chest CT compared to RT-PCR assay and patient outcomes was measured using receiver operating characteristics (ROC). Positive predictive value (PPV) and negative predictive value (NPV) for COVID-19 pneumonia were calculated.Results: 319 patients with a mean age of 62.3 yo were included. Inter-observer agreement for highly probable (kappa: 0.83 [p < .001]) and highly probable or probable (kappa: 0.82 [p < .001]) diagnosis of COVID-19 pneumonia was very good. RT-PCR tests performed in 307 patients were positive in 173 and negative in 134. Sixteen patients with negative RT-PCR tests and probable or highly probable CT patterns according to both radiologists were reclassified COVID-19 positive after clinical discussion. The areas under the curve (AUC) were 0.94 and 0.92 respectively. With a disease prevalence of 61.6%, PPV were 96.6 % and 94.4%, and NPV 84.3% and 78.2%.Conclusion :During acute COVID-19 outbreak, chest CT scan may be used for triage of patients with intermediate clinical probability with very good inter-observer agreements and diagnostic accuracy.

Predictive Value of Decreasing Antithrombin III in Deep-Vein Thrombosis

1980 ◽  
Vol 44 (03) ◽  
pp. 135-137 ◽  
Author(s):  
Thorkild Lund Andreasen
Keyword(s):  
Deep Vein Thrombosis ◽  
Predictive Value ◽  
Coronary Care Unit ◽  
Antithrombin Iii ◽  
Predictive Values ◽  
Vein Thrombosis ◽  
At Iii ◽  
Coronary Care ◽  
Time Of Admission ◽  
Deep Vein

SummaryAntithrombin III (At-III) was measured at the time of admission and two days later in 131 patients laid up in a coronary care unit. The patients were examined for deep-vein thrombosis (DVT) clinically and by means of 125I-fibrinogen scanning. 19 patients developed DVT. In 11 subjects with and 25 without DVT At-III decreased more than 10%. And in 7 with and 17 without DVT At-III decreased more than 15%. One person with DVT had subnormal At-III. By using decrease of At-III or subnormal initial At-III to predict DVT the following predictive value (PV) were found. Decrease ≤ 10%, PV pos.= 0.32 and PV neg. = 0.93. Decrease ≤ 15%, PV pos. = 0.32 and PV neg. = 0.90. The positive predictive values obtained were too low to let decreasing At-III give occasion for prophylactic anticoagulant treatment.

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